Identity commitment in the context of psychosis: a grounded theory study

Abstract

In the context of psychosis, persons encounter problems in self-experience and in the ‘social predicament’ posed by psychiatric diagnosis and unwanted identities. This means they are concerned with self-viability: with how to ‘get along with themselves’. The aim of this study was to develop a grounded theory of how persons deal with this concern of self-viability. Using the ‘classical version’ of grounded theory methodology, data were collected through interviews with eighteen persons with experience of psychosis and psychiatric treatment as well as through examination of eleven autobiographies authored by persons who also had first-hand experience of psychosis. Data were collected and analysed according to established grounded theory research procedures of open and selective coding, memo-writing, and theoretical sampling. The essential theoretical discovery associated with this study is that identity commitment is fundamental to how persons deal with their concern for selfviability in the context of psychosis. This refers to a pattern of self-relation in which persons commit to and are committed by their self-conceptions. There are three modes of identity commitment. The first is keeping true (to) selfconceptions in which persons keep true to, and reproduce truths of, themselves. The second is struggling through with Me’s where persons endeavour to sustain or retrieve identities that are threatened or lost. And the third mode of identity commitment is engaging to identities that incorporates finding things in common with new identities and implication in binding self-attachments. These patterns of truth-keeping, struggle and engagement can inform distinctive understandings of a range of issues in the context of psychosis. Resistance to psychiatric identification, entrapment by unwanted identities, ‘downward’ and ‘upward’ acceptance are particular examples of issues that identity commitment can elucidate. Furthermore, this concept merits further inquiry in the substantive area of psychosis as well as wider fields